YMCA Financial Stability Fund

Hands Across the Bay is no longer coordinating YMCA employee assistance.

The YMCA of the Suncoast is currently working to raise additional funds for this program. If you have any questions, please contact your executive.

Please Fill Out The Form Below:

Full Name*
First Name Middle Name Last Name Suffix
Date of Birth*
MM
DD
YYYY
Please upload a copy of your Photo ID.*
Address*
Street Address Address Line 2 City State ZIP Code
Phone Number*
Email Address*
Preferred Method of Contact*
- Phone
- Email
Have you completed a minimum 12 months of consecutive service working an average at least one shift per pay period for the YMCA of the Suncoast?*
- Yes
- No
Are you currently in good standing with your employer?*
- Yes
- No
(Personnel file may be reviewed as a part of consideration.)
Have all other financial resources been exhausted including unemployment benefits, stimulus dollars and employer loans?*
- Yes
- No
Have you been awarded any funds from this program previously?*
- Yes
- No
How much have you been previously awarded?*
Enter USD
Did this qualifying event occur in the last 180 days?*
- Yes
- No
What type of assistance are you requesting?*
Please explain the circumstance surrounding your request for assistance.
What amount of assistance are you requesting?*
What financial alternative resources (family, retirement fund, banks) have you exhausted?*
Please list a minimum of three.
How many people are in your household?*
Are you or members of your household currently receiving assistance from a government or another not-for-profit program?*
- Yes
- No
(WIC, Food Stamps, Rent Assistance)
What type of assistance are you receiving?*
Do you have an extended history of relying on the government or charitable organizations to pay monthly expenses with no improvement?*
- Yes
- No
Total Monthly Household Income*
Include child support.
What actions are you willing to take to become financially stable?*
Have you received financial planning or credit counseling?*
- Yes
- No
Have you or anyone in your household been arrested for a crime?*
- Yes
- No
What is the nature of the crime and the subsequent rehabilitation?*
This account is funded by a donor that wants to support YMCA staff. Your answer will not impact your eligibility in any way. Would you be willing to:*
- Select All
- Allow us to share your story anonymously with the donor
- Write a thank you note/message to the donor
- I prefer to keep my story private
Application Statement: I have read and fully understand the questions asked in this application. I certify that all of the answers I have given are true, accurate, and complete. I unerstand that the omission and/or misrepresentation of any fact from or on this questionnaire will result in immediate rejection of my application. Unless I noted otherwise, I authorize Hands Across the Bay to contact all of my personal references and do a criminal background check. If assisted, I agree to abide by all rules and regulations of Hands Across the Bay. I understand and agree that nothing in this application shall constitute an offer, a contract, or a guarantee of assistance. I understand that any decision is contingent upon my successful completion of all of the Company's lawful pre-assistance checks, which may include a background check. I agree to execute any consent forms necessary for the Company to conduct its lawful pre-assistance checks. By signing below, I agree to all of the terms stated here.
Date of Application*
MM
DD
YYYY
Consent
I agree to the privacy policy.

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YMCA Financial Stability Fund

Hands Across the Bay is no longer coordinating YMCA employee assistance.The YMCA of the Suncoast is currently working to raise additional funds for this program. If you have any questions, please contact your executive.

Hands Across the Bay is no longer coordinating YMCA employee assistance.

The YMCA of the Suncoast is currently working to raise additional funds for this program. If you have any questions, please contact your executive.